MEDICARE: MS. LENORA STANLEY ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LW0102X	Women's Health Nurse Practitioner	ARNP1151452	FL

General Provider Information

NPI Number	:	1518951177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LENORA STANLEY ARNP

Provider Business Mailing Address
First Line	:	307 BOATNER RD
Second Line	:	SUTIE 114
City	:	EGLIN AFB
State	:	FL
Zip	:	32542-1302
Country	:	US
Telephone Number	:	850-883-8891
Fax Number	:	850-883-2432

Provider Business Practice Location Address
First Line	:	307 BOATNER RD
Second Line	:	SUTIE 114
City	:	EGLIN AFB
State	:	FL
Zip	:	32542-1302
Country	:	US
Telephone Number	:	850-883-8891
Fax Number	:	850-883-8057

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2005
Last Update Date	:	04/25/2018

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